Krzyzaniak, Kenneth E

Krzyzaniak, Kenneth E is an individual health care provider with primary practice located at 823 82Nd Pkwy , Myrtle Beach SC 29572-4607. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Krzyzaniak, Kenneth E can be contacted via phone (843) 449-1010.

Contact Information

Primary practice address
823 82Nd Pkwy Myrtle Beach SC 29572-4607
Phone: (843) 449-1010
Fax: (843) 497-6171
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X MD10499 South Carolina

Profile Details

NPI number 1265423479
LBN Legal business name Krzyzaniak, Kenneth E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Dec 29th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265423479 NPPES
South Carolina Other 771701 WELLCARE
South Carolina MEDICAID 890508M WELLCARE
South Carolina MEDICAID GP1418 WELLCARE
South Carolina MEDICAID GP454522 WELLCARE
South Carolina MEDICAID 104997 WELLCARE
South Carolina Other 340011957 WELLCARE
South Carolina Other 80023039 WELLCARE
South Carolina Other P00360560 WELLCARE

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